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Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice.
Ciprofloxacin Hydrochloride
Brand Name
Ciprofloxacin Hydrochloride
Generic Name
Ciprofloxacin Hydrochloride
Active Ingredient
CiprofloxacinCategory
Fluoroquinolone Antibacterial [EPC]
Salt Form
Hydrochloride
Variants
20
Different strengths and dosage forms
| Strength | Form | Route | NDC |
|---|---|---|---|
| 3 mg/mL | SOLUTION/ DROPS | OPHTHALMIC | 68071-4139 |
| 500 mg/1 | TABLET, FILM COATED | ORAL | 82804-260 |
| 3 mg/mL | SOLUTION/ DROPS | OPHTHALMIC |
References used for this content
This page is for informational purposes only and does not replace medical advice. Before using any prescription or over-the-counter medication for Ciprofloxacin Hydrochloride, you must consult a qualified healthcare professional.
| 250 mg/1 | TABLET, FILM COATED | ORAL | 69367-385 |
| 500 mg/1 | TABLET, FILM COATED | ORAL | 80425-0493 |
| 500 mg/1 | TABLET, FILM COATED | ORAL | 67296-2208 |
| 3 mg/mL | SOLUTION/ DROPS | OPHTHALMIC | 76420-942 |
| 3 mg/mL | SOLUTION/ DROPS | OPHTHALMIC | 63187-985 |
| 500 mg/1 | TABLET, FILM COATED | ORAL | 83939-0002 |
| 3 mg/mL | SOLUTION/ DROPS | OPHTHALMIC | 68788-8198 |
| 500 mg/1 | TABLET, FILM COATED | ORAL | 69367-386 |
| 750 mg/1 | TABLET, FILM COATED | ORAL | 69367-387 |
+ 8 more variants
Detailed information about Ciprofloxacin Hydrochloride
Ciprofloxacin is a potent, broad-spectrum fluoroquinolone antibiotic used to treat various bacterial infections. It works by inhibiting bacterial DNA replication and is available in oral, injectable, and topical forms.
The dosage of Ciprofloxacin varies significantly based on the severity of the infection, the site of the infection, and the susceptibility of the causative organism.
Ciprofloxacin is generally not the first-choice antibiotic for children due to concerns regarding potential damage to developing joints (arthropathy). However, it is FDA-approved for specific pediatric indications:
Since Ciprofloxacin is primarily eliminated by the kidneys, dosage adjustments are mandatory for patients with impaired renal function.
No routine dosage adjustment is generally required for patients with stable hepatic cirrhosis. However, in cases of severe liver failure or combined renal and hepatic impairment, close clinical monitoring is advised.
Selection of dosage for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose (within 6 hours), skip the missed dose and resume your regular schedule. Do not double the dose to catch up.
Signs of overdose may include severe dizziness, tremors, headache, tiredness, or seizures. In the event of an acute overdosage, the stomach should be emptied by inducing vomiting or by gastric lavage. The patient should be carefully observed and given supportive treatment, including monitoring of renal function and administration of magnesium- or calcium-containing antacids to reduce absorption. Hemodialysis only removes about 10% of the drug.
> Important: Follow your healthcare provider's dosing instructions exactly. Do not stop taking the medication early, even if you feel better, as this can lead to the return of the infection and antibiotic resistance.
While many people tolerate Ciprofloxacin well, some experience gastrointestinal or neurological side effects. Common reactions include:
Ciprofloxacin is a high-potency antibiotic that carries significant risks. It must only be used for bacterial infections; it will not treat viral infections like the common cold or flu. Patients must be aware that the risk of serious side effects is higher in certain populations, including those over age 60, those taking corticosteroid medications, and those with organ transplants.
There are several conditions where Ciprofloxacin must NEVER be used because the risk of life-threatening harm is too high:
In these scenarios, a healthcare provider will perform a careful risk-benefit analysis and only prescribe Ciprofloxacin if no other options exist:
Ciprofloxacin is historically classified as FDA Pregnancy Category C. This means that animal studies have shown an adverse effect on the fetus (specifically related to cartilage damage), but there are no adequate and well-controlled studies in humans. Ciprofloxacin should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is generally avoided in the first trimester unless treating life-threatening conditions like anthrax or plague.
Ciprofloxacin is excreted in human breast milk. Because of the potential for serious adverse reactions in nursing infants (including potential damage to developing joints), a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother. If a mother must take Ciprofloxacin, some experts suggest waiting 3 to 4 hours after a dose before breastfeeding to minimize the infant's exposure.
Ciprofloxacin is not recommended as a first-line agent in children under 18 years of age. The primary concern is 'arthropathy'—damage to the cartilage in weight-bearing joints. Clinical trials in pediatric patients have shown an increased incidence of joint-related adverse events compared to control groups. However, the FDA has approved its use for complicated UTIs, pyelonephritis, and post-exposure anthrax prophylaxis when the benefits of treating a severe infection outweigh the risks to the joints.
Ciprofloxacin is a bactericidal antibiotic. At the molecular level, it targets the bacterial enzymes DNA gyrase and Topoisomerase IV. DNA gyrase is responsible for relieving the torsional strain that occurs when the DNA double helix is unzipped for replication. By inhibiting the A-subunit of DNA gyrase, Ciprofloxacin causes the DNA to remain in a 'broken' state, preventing replication. Topoisomerase IV is responsible for separating the two daughter DNA strands after replication is complete. By inhibiting this enzyme, Ciprofloxacin prevents the bacteria from completing cell division. This dual-action mechanism makes it highly effective against a wide range of pathogens.
Ciprofloxacin exhibits concentration-dependent killing. This means that the higher the concentration of the drug relative to the Minimum Inhibitory Concentration (MIC) of the bacteria, the more effective it is. It also possesses a 'Post-Antibiotic Effect' (PAE), where bacterial growth continues to be suppressed even after the drug levels fall below the MIC. Resistance typically develops through mutations in the gyrA or parC genes of the bacteria, or through the development of efflux pumps that push the drug out of the bacterial cell.
Common questions about Ciprofloxacin Hydrochloride
Ciprofloxacin is a broad-spectrum antibiotic used to treat various bacterial infections, including urinary tract infections (UTIs), respiratory infections like pneumonia, and skin or bone infections. It is also a primary treatment for infectious diarrhea caused by certain bacteria and is used for the prevention and treatment of anthrax and plague. Because it is a potent medication, it is typically reserved for infections that cannot be treated with safer, first-line antibiotics. Your doctor will determine if Ciprofloxacin is appropriate based on the type of bacteria causing your illness. It is not effective against viral infections such as the flu or common cold.
The most common side effects reported by patients taking Ciprofloxacin include nausea, diarrhea, and stomach pain. Some people also experience dizziness, lightheadedness, or a mild headache during the first few days of treatment. While these are usually manageable, it is important to stay hydrated and take the medication with food if stomach upset occurs. If you experience severe watery or bloody diarrhea, you should contact your healthcare provider immediately, as this could be a sign of a serious secondary infection. Most mild side effects resolve once the course of antibiotics is completed.
While there is no direct, dangerous chemical interaction between Ciprofloxacin and alcohol, it is generally recommended to avoid alcohol while fighting an infection. Alcohol can worsen the common side effects of Ciprofloxacin, such as dizziness, drowsiness, and upset stomach. Furthermore, alcohol can dehydrate the body and weaken the immune system, potentially slowing down your recovery process. Since Ciprofloxacin requires you to stay well-hydrated to prevent kidney crystals, drinking alcohol is counterproductive. Always consult your doctor for specific advice regarding your lifestyle during treatment.
Ciprofloxacin is generally avoided during pregnancy unless there are no other safe alternatives to treat a serious infection. Animal studies have suggested that fluoroquinolones can cause damage to the developing cartilage and joints of a fetus, leading to the 'Pregnancy Category C' designation. While human data is limited and hasn't definitively proven these risks in babies, doctors prefer to use penicillins or cephalosporins which have a longer safety record in pregnancy. If you are pregnant or planning to become pregnant, you must inform your healthcare provider before starting this medication. They will weigh the risks of the infection against the potential risks to the developing baby.
Most patients begin to feel an improvement in their symptoms within 48 to 72 hours of starting Ciprofloxacin. However, the time it takes to fully clear the infection depends on the severity and location of the illness; for example, a simple UTI may feel better quickly, while a bone infection takes much longer. It is crucial to finish the entire prescribed course of the antibiotic, even if you feel completely better after just a few days. Stopping the medication early allows the strongest bacteria to survive, which can lead to a relapse and the development of antibiotic resistance. If your symptoms do not improve at all after three days, contact your doctor.
You should not stop taking Ciprofloxacin suddenly unless you experience a serious allergic reaction or a severe side effect like tendon pain or nerve tingling. If you stop the medication early because you feel better, the infection may return and be harder to treat the second time. However, if you experience signs of a 'Black Box' warning event—such as sudden joint pain, numbness in your hands, or severe mood changes—you must stop the drug immediately and call your doctor. In these cases, the risk of permanent damage from the drug outweighs the benefit of finishing the course. Your doctor will then switch you to a different class of antibiotic.
If you miss a dose of Ciprofloxacin, take it as soon as you remember, unless it is almost time for your next scheduled dose. If your next dose is less than 6 hours away, skip the missed dose and continue with your regular dosing schedule. Never take two doses at the same time to make up for a missed one, as this increases the risk of side effects and toxicity. To help you remember, try taking your medication at the same time every day, such as with breakfast and dinner. If you miss several doses, contact your healthcare provider for guidance on how to proceed.
Weight gain is not a recognized or common side effect of Ciprofloxacin. Most side effects associated with this medication are gastrointestinal in nature, which more frequently leads to temporary weight loss due to nausea or decreased appetite. However, some patients who experience long-term side effects (FQAD) may notice changes in their metabolism or activity levels due to chronic joint pain, which could indirectly affect weight over a long period. If you notice sudden or significant weight changes while taking an antibiotic, you should discuss this with your doctor to rule out other underlying causes. There is no evidence that short-term use of Ciprofloxacin alters body fat or muscle mass.
Ciprofloxacin has many significant drug interactions that require careful management. It should not be taken with tizanidine, and it must be used very cautiously with theophylline, warfarin, and certain heart medications. Additionally, supplements or antacids containing calcium, magnesium, aluminum, or iron can block the absorption of Ciprofloxacin, making it ineffective. You should space these supplements at least 2 hours before or 6 hours after your antibiotic dose. Always provide your doctor with a complete list of all prescription drugs, over-the-counter medicines, and herbal supplements you are taking to ensure your safety.
Yes, Ciprofloxacin is widely available as a generic medication in several forms, including oral tablets, oral suspension, and eye/ear drops. The generic version is bioequivalent to the brand-name Cipro, meaning it contains the same active ingredient and works the same way in the body. Generic Ciprofloxacin is typically much more affordable than the brand-name version and is covered by most insurance plans. When your doctor prescribes this medication, the pharmacist will likely dispense the generic version unless 'Dispense as Written' is specified. Both the brand and generic versions carry the same FDA black box warnings and safety profiles.
Other drugs with the same active ingredient (Ciprofloxacin)
> Warning: Stop taking Ciprofloxacin and call your doctor immediately if you experience any of these serious symptoms.
Some side effects of Ciprofloxacin may be permanent or long-lasting. This is often referred to as 'Fluoroquinolone-Associated Disability' (FQAD). These long-term effects can involve the tendons, muscles, joints, nerves, and the central nervous system. Patients have reported chronic fatigue, persistent joint pain, and 'brain fog' that lasts for months or years following exposure.
The FDA has issued several 'Black Box Warnings' for Ciprofloxacin, the highest level of safety alert. These include:
Report any unusual symptoms to your healthcare provider immediately. Early detection of serious side effects is critical for preventing permanent damage.
Serious and occasionally fatal hypersensitivity (anaphylactic) reactions have been reported in patients receiving fluoroquinolone therapy. These reactions often occur following the first dose. If a rash or any sign of an allergic reaction occurs, stop the drug immediately.
Rare cases of severe liver damage, including hepatic failure leading to death, have been reported. Most cases of severe liver injury occur within 1 to 3 weeks of starting therapy. If you notice yellowing of the skin or eyes, stop the medication.
Ciprofloxacin may cause CNS events including seizures, dizziness, confusion, tremors, hallucinations, depression, and, rarely, suicidal thoughts or acts. These reactions may occur following the first dose. If these reactions occur, the drug should be discontinued.
Ciprofloxacin has been associated with prolongation of the QT interval on the electrocardiogram (ECG). This can lead to a risk of rare but serious ventricular arrhythmias. Avoid use in patients with known QT prolongation, uncorrected hypokalemia, or those taking Class IA or Class III antiarrhythmic agents.
While on Ciprofloxacin, your healthcare provider may require certain tests to ensure safety:
Ciprofloxacin may cause dizziness, lightheadedness, or confusion. Do not drive, operate heavy machinery, or engage in activities requiring mental alertness until you know how the medication affects you.
While alcohol does not directly interact with Ciprofloxacin's mechanism, both can cause dizziness and stomach upset. It is generally advised to avoid alcohol to prevent compounding these side effects and to allow the body to focus on fighting the infection.
Do not stop taking Ciprofloxacin early without consulting your doctor. However, if you experience signs of tendon pain, nerve tingling, or mental health changes, you must stop the drug immediately and seek medical advice. There is no 'tapering' required for antibiotics, but the full course must be completed unless a serious side effect occurs.
> Important: Discuss all your medical conditions, especially any history of joint problems, nerve issues, or heart rhythm disorders, with your healthcare provider before starting Ciprofloxacin.
For each major interaction, the mechanism usually involves the inhibition of the Cytochrome P450 1A2 enzyme or the physical chelation of the drug in the digestive tract. The clinical consequence is typically either increased drug toxicity or a failure of the antibiotic to treat the infection. Management strategies involve either avoiding the combination, adjusting the dose, or spacing the administration of the two substances.
> Important: Tell your doctor about ALL medications, supplements, and herbal products you are taking, including over-the-counter drugs.
Patients who are allergic to one fluoroquinolone are highly likely to be allergic to others in the class. There is no known cross-sensitivity between Ciprofloxacin and other major antibiotic classes like penicillins or sulfonamides, but patients with multiple drug allergies should be monitored closely for the first dose.
> Important: Your healthcare provider will evaluate your complete medical history, including any history of 'long-haul' symptoms from previous antibiotics, before prescribing Ciprofloxacin.
Patients over the age of 65 are at a significantly higher risk for developing severe side effects from Ciprofloxacin. These include:
For patients with a Glomerular Filtration Rate (GFR) or Creatinine Clearance below 50 mL/min, the dosage must be modified. In patients with severe renal failure (CrCl < 30 mL/min), the half-life of Ciprofloxacin can double, leading to a high risk of CNS toxicity and seizures if the dose is not reduced.
In patients with liver cirrhosis, the pharmacokinetics of Ciprofloxacin are not significantly altered. However, for patients with 'Child-Pugh C' (severe) hepatic impairment, or those with concurrent liver and kidney failure, frequent monitoring of serum levels and clinical symptoms is necessary.
> Important: Special populations require individualized medical assessment and often require lower doses or more frequent monitoring.
|---|---|
| Bioavailability | 70% to 80% (Oral) |
| Protein Binding | 20% to 40% |
| Half-life | 4 hours (Normal renal function) |
| Tmax | 1 to 2 hours |
| Metabolism | Hepatic (15%) via CYP1A2 |
| Excretion | Renal 40-50%, Fecal 20-35% |
Ciprofloxacin belongs to the second generation of fluoroquinolones. It is more potent than first-generation drugs (like nalidixic acid) and has a broader spectrum than many third-generation agents against Gram-negative organisms like Pseudomonas aeruginosa.